Fluid and nutrient intake and risk of chronic kidney disease

Strippoli, Giovanni F.M.; Craig, Jonathan C.; Rochtchina, Elena; Flood, Victoria M; Wang, Jie Jin; Mitchell, Paul

doi:10.1111/j.1440-1797.2010.01415.x

Cited by 157 publications

(152 citation statements)

References 37 publications

(63 reference statements)

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“…Although the relationship between hydration and health is controversial, with many unfounded claims in the popular media [42,43,44], our results are consistent with recent literature showing a specific beneficial effect of hydration on the kidney [18,20,22,23,24,25,45,46,47]. In particular, our results [22] complement a longitudinal analysis of a Canadian cohort in which lower urine volume predicted faster renal decline over follow-up.…”

Section: Discussionsupporting

confidence: 82%

“…In animal models, increased water intake has been shown to reduce proteinuria and slow renal progression [18,20]. In humans, several observational studies show that greater water intake may have a possible protective effect on renal and cardiovascular outcomes [21,22,23,24,25,26]. In a large Canadian cohort, lower urine volume at baseline predicted faster decline in estimated glomerular filtration rate (eGFR) over follow-up [22].…”

Section: Introductionmentioning

confidence: 99%

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Association between Water Intake, Chronic Kidney Disease, and Cardiovascular Disease: A Cross-Sectional Analysis of NHANES Data

et al. 2013

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Background: Evidence from animal and human studies suggests a protective effect of higher water intake on kidney function and cardiovascular disease (CVD). Here the associations between water intake, chronic kidney disease (CKD) and CVD were examined in the general population. Methods: We conducted a cross-sectional analysis of the 2005-2006 National Health and Nutrition Examination Survey. Non-pregnant adults with an estimated glomerular filtration rate (eGFR) ≥30 ml/min/1.73 m² who were not taking diuretics were included. Total water intake from foods and beverages was categorized as low (<2.0 l/day), moderate (2.0-4.3 l/day) and high (>4.3 l/day). We examined associations between low total water intake and CKD (eGFR 30-60 ml/min/1.73 m²) and self-reported CVD. Results: Of 3,427 adults (mean age 46 (range 20-84); mean eGFR 95 ml/min/1.73 m² (range 30-161)), 13% had CKD and 18% had CVD. CKD was higher among those with the lowest (<2.0 l/day) vs. highest total water intake (>4.3 l/day) (adjusted odds ratio (OR) 2.52; 95% confidence interval (CI) 0.91-6.96). When stratified by intake of (1) plain water and (2) other beverages, CKD was associated with low intake of plain water: adjusted OR 2.36 (95% CI 1.10-5.06), but not other beverages: adjusted OR 0.87 (95% CI 0.30-2.50). There was no association between low water intake and CVD (adjusted OR 0.76; 95% CI 0.37-1.59). Conclusions: Our results provide additional evidence suggesting a potentially protective effect of higher total water intake, particularly plain water, on the kidney.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Association between Water Intake, Chronic Kidney Disease, and Cardiovascular Disease: A Cross-Sectional Analysis of NHANES Data

et al. 2013

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“…Our findings are consistent with Strippoli et al, who recently reported a protective effect of higher self-reported fluid intake on kidney function in a large communitybased cohort (21). These findings contrast with earlier studies showing no association or possible harm of greater fluid intake; however, much of this research was conducted in animal models (8) or CKD patients (9).…”

Section: Discussioncontrasting

confidence: 57%

Urine Volume and Change in Estimated GFR in a Community-Based Cohort Study

Clark

Sontrop

Macnab

et al. 2011

Clinical Journal of the American Society of Nephrology

157

146

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SummaryBackground and objectives The effect of increased fluid intake on kidney function is unclear. This study evaluates the relationship between urine volume and renal decline over 6 years in a large community-based cohort.Design, setting, participants, & measurements This prospective cohort study was undertaken in Canada from 2002 to 2008. We obtained 24-hour urine samples from adult participants with an estimated GFR (eGFR) Ն60ml/min per 1.73 m 2 at study entry. Percentage annual change in eGFR from baseline was categorized as average decline Ͻ1% per year, between 1% and 4.9% (mild-to-moderate decline) or Ն5% (rapid decline).Results 2148 participants provided valid 24-hour urine samples, grouped as Ͻ1 L/d (14.5%); 1 to 1.9 L/d (51.5%); 2 to 2.9 L/d (26.3%); and Ն3 L/d (7.7%). Baseline eGFR for each category of urine volume was 90, 88, 84, and 87 ml/min per 1.73 m 2 , respectively. Overall, eGFR declined by 1% per year, with 10% demonstrating rapid decline and 40% demonstrating mild-to-moderate decline. An inverse, graded relationship was evident between urine volume and eGFR decline: For each increasing category of 24-hour urine volume, percentage annual eGFR decline was progressively slower, from 1.3%, 1.0%, 0.8%, to 0.5%, respectively; P ϭ 0.02. Compared with those with urine volume 1 to 1.9 L/d, those with urine volume Ն3 L/d were significantly less likely to demonstrate mild-to-moderate decline (adjusted odds ratio 0.66; 95% confidence interval 0.46 to 0.94) or rapid decline (adjusted odds ratio 0.46; 95% confidence interval 0.23 to 0.92); adjusted for age, gender, baseline eGFR, medication use for hypertension (including diuretics), proteinuria, diabetes, and cardiovascular disease. ConclusionsIn this community-based cohort, decline in kidney function was significantly slower in those with higher versus lower urine volume.

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“…Previous trials and observational studies in humans have demonstrated that high water intake may promote better glucose control, weight loss and decreased cardiovascular risk [21][22][23]. Furthermore, evidence from humans and animals suggests a protective effect of increased hydration/decreased VP on kidney function [24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Effects of hydration on plasma copeptin, glycemia and gluco-regulatory hormones: a water intervention in humans

et al. 2017

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Purpose High plasma copeptin, a marker of vasopressin, predicts diabetes mellitus. We tested if copeptin could be suppressed by increased water intake in healthy individuals, and if a water-induced change in copeptin was accompanied by altered concentrations of glucose, insulin or glucagon. Methods Thirty-nine healthy individuals underwent, in random order, 1 week of high water intake (3 L/day on top of habitual intake) and 1 week of normal (habitual) fluid intake (control). Fasting plasma concentrations of copeptin, glucose, insulin and glucagon were compared between the ends of both periods. Furthermore, acute copeptin kinetics were mapped for 4 h after ingestion of 1 L of water. Results After acute intake of 1 L water, copeptin was significantly reduced within 30 min, and reached maximum reduction within 90 min with on average 39% reduction (95% confidence interval (95 CI) 34-45) (p < 0.001) and remained low the entire test period (4 h). One week of increased water intake led to a 15% reduction (95 CI 5-25) (p = 0.003) of copeptin compared to control week. The greatest reduction occurred among subjects with habitually high copeptin and concentrated urine ("water-responders"). Water-responders had significant water-induced reduction of glucagon, but glucose and insulin were unaffected. Conclusions Both acute and 1 week extra water intake potently reduced copeptin concentration. In those with the greatest decline (water-responders), who are typically low drinkers with high baseline copeptin, water induced a reduction in fasting glucagon. Long-term trials assessing the effect of water on glucometabolic traits should focus on low-water drinkers with high copeptin concentration.

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Fluid and nutrient intake and risk of chronic kidney disease

Abstract: Higher intakes of fluid appear to protect against CKD. CKD may be preventable at a population level with low-cost increased fluid intake.

Cited by 157 publications

References 37 publications

Association between Water Intake, Chronic Kidney Disease, and Cardiovascular Disease: A Cross-Sectional Analysis of NHANES Data

Association between Water Intake, Chronic Kidney Disease, and Cardiovascular Disease: A Cross-Sectional Analysis of NHANES Data

Urine Volume and Change in Estimated GFR in a Community-Based Cohort Study

Effects of hydration on plasma copeptin, glycemia and gluco-regulatory hormones: a water intervention in humans

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